Saw my primary doctor yesterday and she was kind in of to print this for me.Also she said there was a note in my file that i may have to have another nerve/muscle biopsy done.I had one done last year and the samples are to small.Thanks in advance.

Work Copy Only"
Comparison-1/18/2012. Findings: There is a mild levo curvature.Mild endplate compression of the lumbar vertebral bodies is grossly unchanged.Marrow signal is within normal limits, other than end plate degenerative changes,for the patients age. The visualized spinal cord is within normal limits.The conus ends at T12-L1.
Moderate degenerative changes of the disc spaces seen in the mid and lower thoratic disc space.Moderate to servere disc space and facet joint degenerative changes seen at L2-L3, L3-L4.Moderate degenerative changes seen on the rest of the lumbar disc spaces.There has been no significant interval change in the lumbar spine from 1/18/12. In the thoracic disc spaces, mild to moderate endplate degenerative changes seen.Prominent bridging anterior osteophytes seen in the mild and lower thoracic verterbral bodies. At right T2-T3, there is a prominent facet arthropathy with mild encroachment of the right posterior aspect of central canal.No other areas of significant cetral canal narrowing seen.
L1-L2: Prominent disc bulging and moderate facet arthropathy seen.Moderate servere central canal stenosis.Mild right foraminal narrowing seen.L2-L3: Marked end plate degenerative changes present.Moderate disc bulging present.Right paracentral disc protrusion has increased from the previous exam.Moderate bilateral facet arthropathy.Moderate disc bulging and facet arthropathy.Moderate central canal stenosis.Mild bilateral foraminal narrowing.L4-L5:Moderate endplate degenerative changes.Moderate disc bulging with broad based left paracentral disc protrusion.Prominent bilateral facet arthropathy.Moderate severe central canal stenosis.Moderate bilateral foraminal stenosis.L5-S1: Moderate disc bulging and facet arthropathy.No significant stenosis.Moderate degenerative changes of the disc spaces in the mid and lower thoracic disc spaces.Moderate to servere disc space and facet joint degenerative changes seen in the lubar disc spaces.There has been a slight change in the lumbar spine from 1/18/12. At L-2-L3, increased moderate server central canal encroachment seen due to slightly increased disc bulging and right paracentral disc protrusion.The rest of the lumbar disc spaces demonstrate persistent moderate severe central canal encroachment at L1-L2, L3-L-4, at L4-L5 as detailed above. No significant spinal canal narrowing in the thoracic disc spaces. Primary Diagnosit Code: Minor Abnormality.

Any thoughts

I'll try to help Billy:

There are degenerative changes in the disc spaces in the mid and lower thoracic areas. This means that the discs are "flattening" and the vertebra are getting closer together, and since it's degenerative, its going to get worse.

There is moderate to SEVERE disc space and facet joint degenerative changes at L2-3 and L3-4. The facets are the 'wing-like' structures on each side of the spinal cord. If you hunch your back, you can feel them & even see them. There are moderate degenerative changes on the rest of the lumbar disc spaces. This means that all of the lumbar discs are flattening and the vertebra are all getting closer together. There are prominent bone spurs in the mid and lower thoracic vertebra. At the right T2-T3, there is prominent diseased facet with mild encroachment of the right rear of the spinal canal. This means that the facet is pushing on the rear of the spinal canal.

At L1-2 There is a prominent disc bulge and moderate facet disease. There is moderate to severe central canal stenosis. This means that the central spinal canal is getting narrow. Mild right foraminal narrowing is seen at L2-3 -- the foramen are the holes that the nerves pass thru to get to the spinal cord. At L2-3, the holes are narrowing. I'm not sure what the "end plate" degenerative changes means. There is a moderate disc bulge along with a right paracentral disc herniation which has increased from previous exam. There is moderate bilateral facet disease. Moderate central canal stenosis & mild bilateral foraminal narrowing.

L4-5 Moderate disc bulging with broad based with left paracentral disc herniation. Prominent bilateral facet disease. Moderate to severe central canal stenosis (narrowing of the canal) and moderate bilateral foraminal stenosis (narrowing of the foramen)

L5-S1 Moderate disc bulging & facet disease. Moderate degenerative changes of the disc spaces. (Again, the discs are flattening & the vertebra are getting closer together)


From the "Impression" the radiologist says that most of the trouble is the "persistent" encroachment in the lumbar spine, causing spinal canal stenosis. Since this is degenerative, it's not going to get any better and will probably get worse. I would take my films and get an opinion from at LEAST 3 NEUROSURGEONS, and see what they think should be done. You want to stay as CONSERVATIVE as you possibly can. Do NOT jump into surgery, as that should be your LAST RESORT. Surgery will NOT relieve all your pain. Surgery is ONLY for mechanical problems. After surgery, you will still have pain, and sometimes worse than before surgery. So make sure you have at least 3 opinions before opting for surgery as once you do it, you can't "undo" it. I wish you the very best Billy and please let us know what you decide. God bless and take care. If you have any more questions, let us know. Hugs, Lee

I can only add, please get a few more opinions. Also keep a pain journal of just what is going on and bring that with you. Retain a copy of your records when you go doctor to doctor. If you can bring another person along to your appts. it will make keeping track of what is said easier. If you forget something your doctor says, the other person may be able to help. When you are upset, the mind kind of gets numb sometimes. I really hope this has good resolution for you. I will keep you in my toughts and prayers. ginnie

Leesa, A hugh Thank You for breaking down the results for me.I have a follow up on 3/8 and what i know so far is the issues i have in my back may not be causing my foot drop and i may have to have another nerve & muscle biospy.I had one done last yr and the samples where to small and maybe another emg.Iv'e been seeing a neurosurgen for the past 1- 1/2 yr as far as surgery we talked about it and wasn't recommended for the reasons you mention and he recommended me to see a differant neurologist in hopes that she can figure whats going on. I'll know more on the 8th to see what there thinking

Billy it COULD be causing your foot drop. I'm not saying it IS, but it could be. You've got some SEVERE stenosis in places, plus some SEVERE disc space narrowing in places too. So there ARE issues that could be causing foot drop.

A Neurosurgeon could tell you for sure. But don't think that this ISN'T causing the foot drop because it very well could be. Make SURE that you ask about it, okay?

Also, make sure you take the most conservative option you can as far as what they intend to do. Let us know what the doctors say, will you Billy? I'd really like to know. Take care & God bless. Hugs, Lee

Leesa, talked to my 2nd neurologist friday.He thinks my spinal canel and my back is causeing all my issues hes not 100% positive but he's seen worse,he also said back problems affects people differantlly.He also said no to another emg & nerve/Muscle biopsy.With my last nerve biopsy it shows inflamitory process & i have poly neroupthy.Something i didn't know is that when the nerves get sick & die so does the myelin sheath which what is happening with me.This doctor did say afew things that bothered me, 1st- wtf were you sent here, i said a second opinion.2nd we which i assume the vamc don't like to operate on people who smoke.Next step x-ray while i'm standing up called a Flexion & Extension of the lumbar.He did ask if i wanted to have a consultation with a surgen on 3/26 and i said yes.If i opt for surgery they would remove part of the disc which i think that would be called decompressive laminectomy.

Keep in mind Billy, that the decomprression isn't going to get rid of all your pain. Plus it COULD cause the level above/below to fail. So I'm just warning you that you could be in for the same pain and more problems. Personally, unless I was in danger of permanent nerve damage and my spinal cord was being impinged, I wouldn't have surgery.

If he did tell you there was danger of the above, then go ahead. Otherwise, I'd have physical therapy. Take care Billy, Hugs, Lee

What leesa told you is correct. I had the spinal fusion to start with, and wound up having more 6 years later. I am doing OK now, and the pain is less, so in my case that second surgery was the right thing to do. I did have the domino effect, where I failed above and below the first fusion. Try all therapy and do go see a few more neuro surgeons before you make any decision. I really hope that you can be helped. ginnie

Please keep us posted and tell me if you have had shots for this condition often! Take care and may you do well and make a good choice